Thursday, June 27, 2013

Surprise: Th2 cells, inflammation high in both allergic, non-allergic eczema

When I talked to Jon Hanifin last year he mentioned an intriguing fact: eczema comes in two general types. About 80% of atopic eczema patients have allergies and high levels of IgE antibodies. But twenty per cent of patients have eczema without allergies.

The technical term for allergic eczema is “extrinsic” atopic dermatitis; the non-allergic kind is “intrinsic” AD.

Production of IgE—and most antibodies—is activated by type 2 helper T cells. So scientists have generally assumed that extrinsic AD patients had overactive type 2 helper T cells. But new research shows that type 2 helper T cells are overactive in both intrinsic and extrinsic AD patients.

The scientists, led by Emma Guttman-Yassky at Rockefeller University in New York City, analyzed skin and blood samples from 42 extrinsic and 9 intrinsic AD patients, looking at molecular and cellular differences in the immune system and the skin.

They found that type 2 helper T cell activation is actually higher in intrinsic AD patients than extrinsic AD patients. In fact, markers of inflammation in general are higher in intrinsic AD.

Figure 6 from the paper. Scientists now resort to "word clouds" to convey the complexity of molecular biology!
The results are surprising. Patients with intrinsic AD generally do not go on to develop asthma or allergic rhinitis; yet if you just looked at their helper T cells you’d think they were guaranteed to experience even more severe allergies than those suffered by extrinsic AD patients.

So what's keeping down the IgE levels in intrinsic AD? In the paper, the authors speculate freely, but so far there is no answer.

It also appears that a special class of helper T cells known as type 17 (so-called because they produce the signaling molecule IL-17A) are also more active in intrinsic than extrinsic AD. It’s not clear yet how scientists might  use this knowledge to design therapies more specific than current T cell-suppressing options such as ciclosporin, which can have severe side effects.

The research suggests that future T-cell related therapies will likely be similar for intrinsic and extrinsic AD, despite the different nature of the disease in the two patient groups.

Hat tip to KMO.


  1. Hi!

    Thanks so much for the blog and sharing your experiences with eczema.

    I have eczema too, and I just thought I would get in touch to tell you I have set up a small social network over at

    I think your experiences could be really valuable to others, and I would love for you to join.

    Hope to see you on!

    All the best,

  2. Interesting, thanks, I'll check it out!

  3. I have a child with severe eczema and other allergies. She gets so bad in the spring that this year the school hit her with an epi-pen and sent her to the emergency room. I also work for a company that participates in the production of tests kits for various afflictions. Right now, we are looking for adults with high IgE who would like to participate in a plasma program. We are offering great compensation if you qualify. We are located in Charleston, SC but may be able to help with transportation from other locations if you qualify. My name is Danielle Bas and I work for Specialty Sera. I can be reached at 843-766-5544. Just ask for information about the High IgE program. Thank you for sharing such great information.

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